CHAPTER 7

"Doctor, the patient’s blood pressure is dropping fast—seventy over forty!"

The anesthesiologist’s urgent voice echoed through the operating room, slicing through the focused silence that had enveloped the surgical team. The tension in the air was palpable, thick enough to be felt by everyone present. A few beads of sweat formed on the brows of the attending nurses and assistants, but no one hesitated, no one faltered. They were in the middle of a battle against time, and every second counted. But in the midst of it all, Marcus remained composed, his hands steady, his mind razor-sharp. 

Moments like this were nothing new to him. He had long since become accustomed to the high-stakes, life-or-death scenarios that defined his profession. The intensity of an operating room, the weight of another person’s life resting in his hands—this was his reality. People often likened the work of a surgeon to scenes from a medical drama, the kind that left audiences gripping the edge of their seats.

But Marcus knew the truth: real life was far more unpredictable, far less forgiving. At least in films, there was a script. The actors followed a predetermined sequence, knowing exactly what would come next. In this cold, sterile operating room, however, there were no such guarantees. Every decision, every movement, had to be precise. One wrong choice could mean the difference between life and death. 

Yet, the coldness of the room barely registered in his mind. He had no time to think about discomfort or exhaustion, not when something far more pressing demanded his full attention. Lying before him was a fifty-year-old businessman, a man who had likely spent his life making tough decisions, closing deals, and navigating corporate battles. But none of that mattered now. Right now, he was a patient fighting for survival, his life hanging in the balance.

His heart, the organ responsible for keeping him alive, was failing him. A heart attack had struck him down in the middle of a meeting, the result of nearly completely blocked coronary arteries. Without immediate intervention, he wouldn’t make it. Marcus knew the statistics, knew how critical every second was in cases like this. But beyond the numbers and the science, there was one simple, undeniable truth—this man needed him, and Marcus would do everything in his power to save him.

Despite the immense pressure closing in around him, Marcus remained unfazed. His years of experience in the operating room had trained him to keep a steady hand and a clear mind, no matter the circumstances. He had seen patients teeter on the edge of life and death before, had fought battles against failing hearts and narrowing arteries, and he understood that in moments like this, hesitation was the enemy.

As a cardiothoracic surgeon, he carried the immense responsibility of making decisions in mere seconds—decisions that could mean the difference between a second chance at life or a final breath. One wrong move, one misplaced suture, and the man lying on the table before him would never wake up again. It was a possibility he refused to accept. He hadn't spent years mastering his craft just to lose a patient tonight. Not if he could help it. 

"We’re out of time. Initiate cardiopulmonary bypass now," Marcus instructed, his voice cutting through the tension like a blade.

His tone was steady, commanding, a stark contrast to the urgency of the situation. There was no room for fear, no space for panic. Only precision. Only control. His team responded immediately, each member moving with well-practiced efficiency.

A perfusionist took charge of the heart-lung machine, a crucial piece of equipment that would temporarily take over the heart’s function, ensuring that oxygen-rich blood continued to circulate throughout the patient’s body while Marcus worked. If this machine failed, if even the smallest mistake occurred, the consequences would be catastrophic. But he had faith in his team. They had been through this before. 

As the machine hummed to life, Marcus and his assistant wasted no time in preparing to place the aortic cross-clamp, a critical step in the bypass procedure. The clamp would halt blood flow through the heart, allowing them to operate without interference. Carefully, with the precision of a seasoned expert, Marcus positioned the instrument, ensuring it was secure before signaling to his assistant.

Around him, the room was alive with movement—monitors beeped in a steady rhythm, nurses called out vital signs, and the faint sound of the ventilator filled the space. But none of it distracted him. His focus was unshakable. Every action he took was calculated, every decision deliberate. He was at war with time, battling against the odds to restore life to the struggling heart before him. And he would not—could not—lose.

"Scalpel," Marcus said, extending his gloved hand toward the scrub nurse.

Without hesitation, the instrument was placed into his palm, its cool metal handle familiar against his fingers. He took a steady breath, then made the first incision—clean, precise, neither too deep nor too shallow. Every movement was deliberate, every stroke of the blade a result of years of training and countless procedures. There was no room for error. As the first layers of skin and tissue parted beneath his skilled hands, he focused solely on the task before him, his mind shutting out every other distraction. Around him, his team worked in perfect synchrony, the rhythmic beeping of the monitors a constant reminder of the fragile life in their hands.  

Within minutes, he reached the sternum, the thick, protective bone that shielded the heart and lungs. “Sternal saw," he instructed, and the nurse promptly handed over the buzzing tool.

The sharp whir of the rotating blade filled the operating room, slicing through the bone with mechanical efficiency. The sound was harsh, grating, a noise that could easily make an untrained observer uneasy, but in this setting, it was routine. No one flinched, no one hesitated. The team remained steadfast in their roles, each person focused on the intricate dance of saving a life. Marcus worked swiftly but carefully, ensuring the sternum was cleanly divided before using a retractor to open the chest cavity further. And there it was—the heart, barely moving, its weak contractions a dire sign of just how critical the situation had become. 

His assistant, who had been monitoring the exposed organ, wasted no time in confirming what Marcus already suspected. "Severe blockage confirmed. We need to proceed with the bypass immediately."

Marcus gave a firm nod, his jaw tightening in determination. He had seen cases like this before, hearts struggling to hold on, their vessels clogged with years of built-up plaque, the very lifeline of the body being choked off. But there was still a chance. He glanced at the prepared saphenous vein graft, the key to rerouting blood flow and restoring circulation. Time was of the essence. Every second mattered. Without another word, he steadied his hands and got to work—because for this patient, for this heart, failure was not an option.

Marcus gave a curt nod. "Prepare the saphenous vein graft. We’ll use it to bypass the occluded artery." 

As soon as the vein graft, harvested from the patient’s leg, was prepared, Marcus began the delicate procedure of rerouting the blood flow. His hands moved with meticulous precision, as if guided by an unspoken rhythm. Every motion had a purpose, every suture placed with unwavering skill. 

"Doctor, hypotension persists," the anesthesiologist warned, his voice laced with urgency.

The tension in the room thickened, but Marcus didn’t allow it to rattle him. Instead, he turned his gaze toward the monitor, watching as the patient’s blood pressure continued to drop. Seventy over forty. Then sixty-five. The numbers were falling too quickly. Every second counted. His mind worked at lightning speed, assessing the situation, calculating his next steps. The bypass was in progress, but the heart was still struggling. If they didn’t stabilize him now, the damage could be irreversible.  

"Increase perfusion pressure," Marcus ordered, his voice calm but firm, leaving no room for hesitation.

The perfusionist immediately adjusted the settings on the heart-lung machine, increasing blood flow to maintain circulation while the surgery continued. Marcus could hear the change in the rhythmic hum of the machine, the subtle shift in the way the artificial circulation worked to sustain the patient’s body. But it wasn’t enough. The numbers on the monitor were still dangerously low. His gaze hardened. They needed pharmacological intervention—immediately.  

"Give me 10cc of epinephrine, stat!" he commanded.

A nurse swiftly handed him the syringe, and without missing a beat, he injected the life-saving drug directly into the patient’s system. Epinephrine would help constrict the blood vessels, raising blood pressure and supporting the heart’s weakened contractions. Now, they had to wait—mere seconds that felt like an eternity. The team held their breath as the monitor beeped in steady succession. Then, a shift. The numbers ticked up—seventy over fifty, then seventy-five. It was working. Relief was fleeting, though. They weren’t in the clear yet. Marcus tightened his grip on the surgical instruments. The real battle was still ahead—repairing the heart before it failed entirely.

Without pausing, Marcus continued securing the graft to the coronary artery, his hands moving with practiced precision. Every suture had to be perfect, every knot secure. There was no room for error. The graft, harvested from the patient’s saphenous vein, was now the lifeline that would bypass the blocked artery and restore proper blood flow to the heart. He worked swiftly but meticulously, ensuring that the delicate vessel connections were flawless. Each second that passed was crucial—any delay, any misstep, and the heart could falter. His focus was absolute, his hands steady despite the pressure weighing down on him.  

"Releasing cross-clamp," Marcus announced, his voice firm but composed.

His team exchanged quick, knowing glances, fully aware of what came next. He moved with care as he slowly removed the clamp from the aorta, the large artery responsible for distributing oxygen-rich blood from the heart to the rest of the body. The moment the clamp was released, the blood—previously rerouted through the heart-lung machine—began flowing back into the heart, filling its chambers. It was a critical moment, the true test of whether the bypass had been successful.  

A thick, almost suffocating silence settled over the operating room. No one spoke, no one moved unnecessarily. Every eye was fixed on the heart monitor, watching, waiting. The heart had to respond, had to take over its function again without faltering. If it failed to beat on its own, if the rhythm didn’t return, Marcus would have to intervene immediately. The weight of responsibility pressed down on his shoulders, but he remained motionless, his gaze locked onto the monitor.  

Then— Beep. Beep. Beep.

The soft but steady sound broke through the silence. The green waveform on the monitor pulsed in a rhythmic pattern. The heart had stabilized. Blood was flowing. The bypass was holding. A collective breath was released, tension dissipating from the team like air escaping a balloon.  

"Normal sinus rhythm," the nurse announced, her voice tinged with relief.

For the first time since the procedure had begun, the tightness in Marcus’s chest loosened. He didn’t show it, didn’t allow the moment to slow him down. There was still work to do. But in that brief instant, he allowed himself to acknowledge it—another life saved, another battle won.

As the steady beeping of the heart monitor filled the room, a silent wave of tension lifted. Shoulders relaxed, breaths evened out, and the once-stiff atmosphere softened. Marcus, however, remained composed. He didn’t show it, but deep down, he felt the same relief washing over him. The most critical part of the surgery—the battle to restore the heart’s function—was over. But he knew better than to lower his guard just yet. A single complication could undo everything they had fought for. His patient wasn’t completely out of danger until the final suture was in place and the body proved strong enough to sustain itself.  

"Check for bleeding. If there are no signs of hemorrhage, we’ll proceed with closing," he instructed, his voice steady but firm.

His team immediately complied, scanning the surgical site with careful precision. Every vessel had to be examined, every stitch secure. Even the slightest uncontrolled bleed could turn into a catastrophe. Marcus observed as his assistants moved efficiently, scanning for leaks, ensuring that no silent danger lurked beneath the surface. The seconds stretched, but soon, the verdict was in—no active bleeding. The bypass held perfectly. It was time to close.  

Satisfied, Marcus reached for the sutures and began the delicate process of sealing the heart. His movements remained precise, each stitch reinforcing the patient’s fragile second chance at life. Layer by layer, he worked his way back—suturing the heart, securing the sternum, then meticulously closing the muscle and skin. This part of the procedure demanded as much care as the operation itself. Any misstep could cause complications in healing, infections, or even structural weaknesses. His hands didn’t waver, his concentration didn’t break. With each careful stitch, he ensured that this man, this heart, had the best possible chance of recovery.  

Five hours had passed, though it felt like mere moments. The intensity of the operation had made time slip away unnoticed. But now, standing at the threshold of success, Marcus finally allowed himself a brief pause. He took a step back, peeling off his gloves with deliberate slowness before removing his mask. His gaze lingered on the monitor beside him, watching the strong, rhythmic beating of the patient’s heart. It was steady. Strong. Alive. The ultimate reward.  

This was why he endured the exhaustion, the pressure, the endless nights without sleep. This moment—the proof of their effort, the life they had saved—was worth every second of sacrifice. Though his work was far from over, and another surgery awaited just beyond these walls, Marcus allowed himself one fleeting victory. Then, with the same quiet determination, he turned and walked toward the door, ready for whatever came next.

"Great job, everyone," Marcus said, his voice calm but laced with a quiet appreciation.

He gave a small, sincere smile to the team before turning to leave the operating room. The team had done their part, and now the patient was in recovery. The most critical part was over, but Marcus knew better than to think everything was guaranteed just yet. The next few hours would still be crucial. He couldn’t afford to let his guard down completely.

His strides were long and purposeful as he walked down the sterile hospital corridor, the faint hum of medical equipment echoing in the background. The familiar scent of antiseptic lingered in the air, a reminder of the intense work he had just completed. His mind was already shifting gears, preparing for the next challenge, but his body was exhausted. His eyes scanned the hallway briefly before he saw them—standing near the waiting area outside the surgical suite, their faces filled with anxiety.

The family was waiting. Marcus could see the fear in their eyes, the tension in their bodies, as they shifted from foot to foot. The weight of uncertainty pressed down on them. He could feel the heaviness of the room, thick with the unspoken worries of the patient’s loved ones. They didn’t know yet whether their father, husband, or brother would survive the night. Marcus knew how much this moment mattered. It wasn’t just about medical procedures—it was about lives and families, emotions too complex to be handled in the cold, methodical way of a surgeon.

The patient’s wife stepped forward first, her hands nervously clasped in front of her. Her face was pale, and her lips trembled as she looked up at Marcus.

"D-Doctor…?" she asked, her voice barely a whisper, thick with fear and hope.

The silence that followed seemed to stretch for an eternity as she waited for his response. Every pair of eyes in the room was fixed on him. There was no room for error, no room for doubt. They needed this moment of clarity.

A small but sincere smile tugged at Marcus’s lips, a gesture meant to ease their tension, to reassure them that the worst was behind them. He wiped the sweat from his brow, finally letting the exhaustion show in the slight sag of his shoulders, before responding with the calm certainty that had carried him through the surgery.

"The surgery was a success. He’s going to be okay," he said, his voice steady and sure.

He saw the immediate release of breath from the family, their shoulders relaxing, eyes softening as the words sank in. Relief, joy, and tears all seemed to fill the space at once. It was always the same, this raw outpouring of emotion that followed the life-changing moment. Marcus allowed himself a quiet, internal sigh of relief. He had done his job, and the family had their hope back.

For a moment, silence enveloped them, the kind that only comes when words can’t quite capture the depth of emotion in the room. The family stood there, eyes wide with the weight of the news they had just received, trying to process the relief that was flooding in. Then, like a dam breaking open, the dammed-up emotions came pouring out. The wife, her hands still trembling, collapsed into the arms of her children as they all wept together. The tears were a mixture of relief, gratitude, and overwhelming joy—tears for the man who had been so close to death, but who was now on his way to recovery. It was as if they had been carrying an invisible burden all this time, and with one simple declaration, it was gone.

Marcus watched them, standing a few feet away, allowing them to have their moment. It was something he had seen countless times before—the tearful thanks, the tight embraces, the outpouring of gratitude from families who had been through a nightmare and now saw the light at the end of the tunnel. For him, it was routine. It was expected. And yet, no matter how many times it happened, no matter how familiar the scene became, it never lost its power. Every single time, he still felt it—a warmth blooming in his chest, a quiet sense of fulfillment that couldn’t be explained away by experience. It was something deeper, something that transcended routine and became personal.

The patient’s children, their faces still wet with tears, turned toward Marcus, their eyes wide with a mixture of awe and pure gratitude. They approached him cautiously, unsure whether they should be giving him a hug, shaking his hand, or simply bowing in reverence. But in the end, it was the words they spoke that mattered most.

 "Thank you, Doctor," one of them said, voice thick with emotion.

 "You saved his life. You gave us our father back." Others nodded, words of thanks falling from their lips in a flood.

The expression on their faces—their relief, their admiration—was enough to make Marcus’s heart swell. He wasn’t just a doctor to them. In that moment, he was their hero, their savior.

It was a scene Marcus had lived through many times. The gratitude, the tears, the overwhelming emotions from families who had just witnessed a loved one being given a second chance at life. By now, he should be used to it, shouldn’t he? Yet, each time, it felt just as raw and meaningful as the first. He knew the mechanics of the moment, understood it from every angle—but still, it touched something deep inside him, something that he couldn’t ignore or grow numb to. Because, no matter how often it happened, no matter how many lives he had touched, it always felt personal. It always mattered. And that was the part of being a surgeon that would never fade.

After a few more moments, Marcus excused himself from the family, giving them the space to gather their emotions. He quietly made his way down the corridor toward his office, his footsteps steady but light. As he walked, he couldn't help but smile to himself. This was why he became a doctor.

In the whirlwind of surgeries, the endless hours, and the pressure that always seemed to hang over him, these moments—the ones where he could see the direct impact of his work—were the ones that made everything worthwhile. When a life was saved, when a family was spared the crushing grief of loss, he was reminded of the purpose that had driven him to this profession in the first place.

 It wasn’t about the prestige, or the recognition, or even the money—it was about making a real difference. These were the moments that made the sacrifices, the sleepless nights, and the years of hard work all worth it.

As he walked, Marcus thought about his mother, Juliana. He could almost hear her voice in his head, warm and full of pride. She had always been his greatest supporter, the one who had encouraged him to follow his passion, to become a doctor. Juliana had believed in his calling before he fully understood it himself.

She had been his rock, his biggest fan, cheering him on every step of the way. Marcus had always felt her unwavering faith in him, even on the darkest days when self-doubt crept in. He was sure that, wherever she was now, she would be proud of him—proud of the man he had become, and proud of the difference he was making in the world. For all the times he had questioned his choices, Juliana had never wavered. She had always known that he was meant to heal, to help, to save.

But as the memory of his mother warmed his heart, the thought of his father, Mario, caused the smile to fade. The shift was almost imperceptible, but it was there.

He was used to moments like this—the joy, the gratitude, the tearful embraces. But beyond the praises and the success, his profession carried a weight. A promise. A responsibility he could never break. 

And just like that, the familiar ache returned. The bitterness of the past. The longing. The quiet thirst for justice. 

His vision blurred for a moment, but he blinked it away. 

If it weren’t for him, if it weren’t for what happened—his family would still be whole. 

Marcus let out a deep breath. 

Marcus didn’t walk away from the operating room to rest. He walked away with a singular purpose, a focused determination that was deeply ingrained in him. The sense of relief he had felt just moments before, the victory of saving a life, was fleeting—like a passing cloud. There was no time to savor it. There was no room for complacency in his world. The stark reality of his profession dictated that the work never stopped.

No matter how taxing the previous surgery had been, there was always another patient waiting, always another life hanging in the balance. In just an hour, he would step into another operating room, face another set of challenges, and take another oath to fight for someone else’s survival. It was a rhythm he knew all too well—a relentless, unforgiving cycle that never paused, never took a break.

The pressure of his work never let up. He had long since learned that in this line of work, rest wasn’t a luxury—it was a distant dream. The need to stay sharp, to be fully alert, to maintain an unwavering focus, was paramount. Each surgery was unique, each patient a new puzzle with a different set of risks, complications, and outcomes. No two cases were the same, and so Marcus had to approach each one with the precision and care of someone who had no room for error.

It was not just a matter of skill—it was a matter of life and death. While others could clock out, enjoy their evenings, or sleep peacefully, Marcus knew that his duty called for something more. It demanded everything he had—every ounce of energy, every ounce of attention, every moment of his life. Rest could wait.

As he walked down the corridor, he felt the weight of his responsibilities settle around him once again. It was an unrelenting burden, but one he had accepted long ago. It wasn’t a question of whether he could rest—it was a question of whether he could afford to. There was always someone else depending on him, always someone else who needed his expertise, his hands, his mind. No amount of exhaustion, no matter how deep, could change that fact. This was the price he paid for his calling, and he had long ago made peace with it.

 In his world, the stakes were too high to falter, too urgent to take a break. As he entered his office, his thoughts focused on the next surgery ahead, he knew there was no other choice. Rest wasn’t an option—not when another life was waiting for him to save it.